...we combined the opinions of frontline epidemic control experts and reviewed the evidence in relevant literature. Two members of the evidence assessment team performed independent computer searches ...of English databases (PubMed, Ovid, Embase), Chinese databases (Chinese Biological Medical Literature database, China National Knowledge Infrastructure, Chinese Medical Journal Database), and relevant online website bulletins on COVID-19 (the World Health Organization, Elsevier, the Lancet, the New England Journal of Medicine, and the Journal of the American Medical Association, 2019 Novel Coronavirus Resource (2019nCoVR), and the Chinese Medical Journal Network). The search terms included the English terms and their Chinese equivalents: “novel coronavirus pneumonia,” “NCP,” “severe acute respiratory syndrome,” “SARS,” “Middle East Respiratory Syndrome,” “MERS,” “influenza,” “psychological therapy,” “guideline,” “statement,” “recommendation,” “randomized controlled trial,” and other rehabilitation-related English search terms and their Chinese equivalents included “respiratory rehabilitation,” “pulmonary rehabilitation,” “physiotherapy,” “physical therapy,” and “occupational therapy.” 11 Recommendations Intervention timing for respiratory rehabilitation in moderately ill patients Due to the limited understanding of the pathophysiological mechanisms of COVID-19, current clinical observations found that around 3% to 5% of moderately ill patients develop severe or even critical disease after 7 to 14 days of infection. ...the exercise intensity should not be too high as its objective is to maintain the existing physical status.
Global warming has obtained more and more attention because the global mean surface temperature has increased since the late 19th century. As more than 50% of the human population lives in cities, ...urbanization has become an important contributor for global warming. Pearl River Delta (PRD) in Guangdong Province, southern China, is one of the regions experiencing rapid urbanization that has resulted in remarkable Urban Heat Island (UHI) effect, which will be sure to influence the regional climate, environment, and socio-economic development. In this study, Landsat TM and ETM+ images from 1990 to 2000 in the PRD were selected to retrieve the brightness temperatures and land use/cover types. A new index, Normalized Difference Bareness Index (NDBaI), was proposed to extract bare land from the satellite images. Additionally, Shenzhen, which has experienced the fastest urbanization in Guangdong Province, was taken as an example to analyze the temperature distribution and changes within a large city as its size expanded in the past decade. Results show that the UHI effect has become more prominent in areas of rapid urbanization in the PRD region. The spatial distribution of heat islands has been changed from a mixed pattern, where bare land, semi-bare land and land under development were warmer than other surface types, to extensive UHI. Our analysis showed that higher temperature in the UHI was located with a scattered pattern, which was related to certain land-cover types. In order to analyze the relationship between UHI and land-cover changes, this study attempted to employ a quantitative approach in exploring the relationship between temperature and several indices, including the Normalized Difference Vegetation Index (NDVI), Normalized Difference Water Index (NDWI), Normalized Difference Bareness Index (NDBaI) and Normalized Difference Build-up Index (NDBI). It was found that correlations between NDVI, NDWI, NDBaI and temperature are negative when NDVI is limited in range, but positive correlation is shown between NDBI and temperature.
Vitamin D can not only regulate calcium and phosphorus metabolism, but also exert an immunoregulatory effect. Vitamin D deficiency is common in patients with Crohn's disease (CD). Studies have shown ...that vitamin D is associated with CD and other autoimmune diseases and can improve the condition of patients with CD and promote their recovery by regulating intestinal immunity, repairing the intestinal mucosal barrier, inhibiting intestinal fibrosis, enhancing the response to infliximab, and regulating intestinal microbiota. Exogenous vitamin D supplementation can induce disease remission while increasing the serum level of vitamin D. However, only a few randomized, double-blind, and placebo-controlled trials have investigated the therapeutic effect of vitamin D in CD, and the optimal form of vitamin D supplementation, the specific dosage of vitamin D supplementation, and the optimal serum maintenance concentration of vitamin D remain to be clarified. This article mainly discusses the mechanism of action of vita
Purpose
The aim of this study was to analyze the role of ultrasound-guided vacuum-assisted excision (US-guided VAE) in the treatment of high-risk breast lesions and to evaluate the clinical and US ...features of the patients associated with recurrence or development of malignancy.
Materials and methods
Between April 2010 and September 2021, 73 lesions of 73 patients underwent US-guided VAE and were diagnosed with high-risk breast lesions. The incidence of recurrence or development of malignancy for high-risk breast lesions was evaluated at follow-up period. The clinical and US features of the patients were analyzed to identify the factors affecting the recurrence or development of malignancy rate.
Results
Only benign phyllodes tumors on US-guided VAE showed recurrences, while other high-risk breast lesions that were atypical ductal hyperplasia (ADH), lobular neoplasia (atypical lobular hyperplasia/lobular carcinoma in situ), radial scar, and flat epithelial atypia did not show recurrences or malignant transformation. The recurrence rate of the benign phyllodes tumor was 20.8% (5/24) in a mean follow-up period of 34.3 months. The recurrence rate of benign phyllodes tumor with distance from nipple of less than 1 cm was significantly higher than that of lesions with distance from nipple of more than 1 cm (75% vs. 10%,
p
< 0.05).
Conclusions
Benign phyllodes tumors without concurrent breast cancer could be safely followed up instead of surgical excision after US-guided VAE when the lesions were classified as BI-RADS 3 or 4A by US.
Changes in nitrogen (N) deposition and litter mixtures have been shown to influence ecosystem processes such as litter decomposition. However, the interactive effects of litter mixing and ...N‐deposition on decomposition process in desert regions remain poorly identified. We assessed the simultaneous effects of both N addition and litter mixture on mass loss in a litterbag decomposition experiment using six native plants in single‐species samples with diverse quality and 14‐species combinations in the Gurbantunggut Desert under two N addition treatments (control and N addition). The N addition had no significant effect on decomposition rate of single‐species litter (expect Haloxylon ammodendron), whereas litter mass loss and decomposition rate differed significantly among species, with variations positively correlated with initial phosphorus concentration and negatively correlated with initial lignin concentration. After 18 months, the average mass loss across litter mixtures did not overall differ from those predicted from single species either in control or N addition treatments, that is, mixing of different species had no non‐additive effects on decomposition. The N addition, however, did modify the direction of mixture effects and interacted with incubation time. Added N transformed synergistic effects of litter mixtures to antagonistic effects on mass loss after 1 month of decomposition, while transforming neutral effects of litter mixture to synergistic effects after 6 months of decomposition. Our results demonstrated that initial chemical properties played an important role in litter decomposition, while no effects of litter mixture on decomposition process in this desert region. The N addition altered the litter mixture effects on mass loss with incubation time, implying that increased N deposition in the future may have profound effects on carbon turnover to a greater extent than previously thought in desert ecosystems.
This paper demonstrated that the initial chemical properties played an important role in litter decomposition, while no effects of litter mixture on decomposition process in this desert region. The N addition altered the litter mixture effects on mass loss with incubation time, implying that increased N deposition in the future may have profound effects on carbon turnover to a greater extent than previously thought in desert ecosystems.
Current software technology facilitates the essential components of a rehabilitation program, namely assessment, education, prescription, and monitoring of exercise programs; advice on medication, ...nutrition, and lifestyle modification; and program evaluation. Hansen et al6 demonstrated that the participation rate of patients with COPD in “remote”/home-based pulmonary rehabilitation was significantly greater compared with a traditional hospital-centered program. Considering the pandemic characteristics of COVID-19, traditional Chinese exercise (Tai Chi and Baduanjin) has unique advantages, since physical movements are small and the space requirement is not substantial. ...exercise is suitable for home practice during the COVID-19 pandemic. From the point of view of improving symptoms, functional status, and promoting health-related quality of life, pulmonary rehabilitation has several advantages that cannot be replaced by medical treatment.
Background
To evaluate the value of ultrasound-guided vacuum-assisted excision (US-guided VAE) in the treatment of intraductal papillomas, including intraductal papillomas with atypical ductal ...hyperplasia (ADH), and to evaluate the lesion characteristic features affecting the local recurrence rate.
Materials and methods
Between August 2011 and December 2020, 91 lesions of 91 patients underwent US-guided VAE and were diagnosed with intraductal papilloma with or without ADH. The recurrence rate of intraductal papilloma was evaluated on follow-up US. The lesion characteristic features were analyzed to identify the factors affecting the local recurrence rate.
Results
The local recurrence rate of intraductal papillomas removed by US-guided VAE was 7.7% (7/91), with the follow-up duration 12–92 months (37.4 ± 23.9 months). Of the 91 patients, five cases diagnosed as intraductal papilloma with ADH did not recur, with the follow-up time 12–47 months (26.4 ± 14.4 months). There were no malignant transformation in all 91 cases during the follow-up period. All 7 patients recurred 7–58 months (22.8 ± 19.2 months) after US-guided VAE. There were no significant differences between the non-recurrence and recurrence groups in terms of age, side, distance from nipple, lesion size, BI-RADS category, with ADH, or history of excision (
p
> 0.05).
Conclusions
US-guided VAE is an effective method for the treatment of intraductal papilloma, including intraductal papilloma with ADH. It avoids invasive surgical excision, but regular follow-up is recommended to prevent recurrence or new onset due to multifocality. Any suspicious lesions during the follow-up should be actively treated.
To explore the characteristics and prognostic significance of genetic mutations in acute myeloid leukemia (AML), we screened the gene mutation profile of 171 previously untreated AML patients using a ...next‐generation sequencing technique targeting 127 genes with potential prognostic significance. A total of 390 genetic alterations were identified in 149 patients with a frequency of 87.1%. Younger age and high sensitivity to induction chemotherapy were associated with a lower number of mutations. NPM1 mutation was closely related to DNMT3A and FLT3‐internal tandem duplication (FLT3‐ITD) mutations, but mutually exclusive with ASXL1 mutation and CEBPAdouble mutation. In univariate analysis, ASXL1 or TET2 mutation predicted shorter overall survival (OS) or relapse‐free survival (RFS), DNMT3A, FLT3‐ITD, or RUNX1 mutation predicted a higher likelihood of remission‐induction failure, whereas NRAS mutation or CEBPAdouble mutation predicted longer OS. Concurrent DNMT3A, FLT3‐ITD, and NPM1 mutations predicted shorter OS. Hypomethylation agents could improve the OS in patients with DNA methylation‐related mutations. According to multivariate analysis, TET2 mutation was recognized as an independent prognostic factors for RFS. In summary, our study provided a detailed pattern of gene mutations and their prognostic relevance in Chinese AML patients based on targeted next‐generation sequencing screening.
Genetic mutations can predict favorable or unfavorable prognosis of AML patients. Allo stem cell transplantation can provide benefits for AML patients with bad genetic mutations.
To investigate the nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease (IBD).
A retrospective analysis was conducted on the clinical data of ...children who were diagnosed with IBD for the first time in Hunan Children's Hospital from January 2015 to December 2021. Diagnostic delay was defined as the time from the symptom onset to IBD diagnosis being in the upper quartile (
-
) of all IBD children in the study. Multivariate logistic regression analysis was used to explore the risk factors for emaciation and growth retardation.
A total of 125 children with newly diagnosed IBD were included, with Crohn's disease being the main type (91.2%). The rates of emaciation and growth retardation were 42.4% (53 cases) and 7.2% (9 cases), respectively, and the rate of anemia was 77.6% (97 cases). Diagnostic delay was noted in 31 children (24.8%), with the time from the symptom onset to IBD diagnosis of 366 to 7 211 days. Multivariate logistic regression analysis showed th
PDF
